UnitedHealthcare — Denial Rates & Appeal Data
Compare against every insurer we track: denial rates ranked within reporting cohorts.
COVERAGE RIGHTS ROLLUP · CALCULATED FROM UNITEDHEALTHCARE PUBLIC DISCLOSURES
Coverage Rights rollup computed from UnitedHealthcare's 63 posted Medicare Advantage contract disclosures. The 12.9% denial rate combines 7,942,400 standard and 651,232 expedited requests. The 57.7% appeal figure combines 63,314 reversals across 109,681 standard and expedited appeals; appeal volumes are derived from UHC's posted overturned counts and percentages. UHC separately publishes a 91.7% approved headline on a different reporting basis, so the two figures should not be compared directly. Every contract row used here appears below and in the downloadable CSV.
UNDERLYING SOURCE: UNITEDHEALTHCARE CMS-0057-F DISCLOSURE, CY2025 · VIEW SOURCE ↗ · METHODOLOGY
Metrics by contract / plan
| Contract / plan | Line | Requests | Denied | Appeals overturned | Avg decision | Source |
|---|---|---|---|---|---|---|
| H2001 UnitedHealthcare | Medicare Advantage | 1,854,050 | 23.4% | 56.9% | 1d | Source |
| H0543 UnitedHealthcare | Medicare Advantage | 1,569,659 | 1.8% | 82.3% | 0d | Source |
| H0609 UnitedHealthcare | Medicare Advantage | 705,296 | 7.3% | 81.7% | 0d | Source |
| H5253 UnitedHealthcare | Medicare Advantage | 643,001 | 18.9% | 55.9% | 1d | Source |
| H2406 UnitedHealthcare | Medicare Advantage | 416,396 | 17.3% | 62.1% | 1d | Source |
| H8768 UnitedHealthcare | Medicare Advantage | 310,977 | 20.6% | 55.8% | 1d | Source |
| H4527 UnitedHealthcare | Medicare Advantage | 257,844 | 3.4% | 93.7% | 0d | Source |
| H4514 UnitedHealthcare | Medicare Advantage | 226,988 | 4.8% | 90% | 0d | Source |
| H1278 UnitedHealthcare | Medicare Advantage | 213,495 | 4.5% | 85.8% | 0d | Source |
| H2802 UnitedHealthcare | Medicare Advantage | 203,602 | 20.6% | 55.9% | 1d | Source |
| H1045 UnitedHealthcare | Medicare Advantage | 182,207 | 17.8% | 47.5% | 1d | Source |
| H1889 UnitedHealthcare | Medicare Advantage | 178,418 | 17.1% | 56.8% | 1d | Source |
| H5322 UnitedHealthcare | Medicare Advantage | 135,667 | 9% | 61.6% | 0d | Source |
| H3805 UnitedHealthcare | Medicare Advantage | 106,551 | 14.5% | 62.1% | 1d | Source |
| H0294 UnitedHealthcare | Medicare Advantage | 90,700 | 19.8% | 49.1% | 1d | Source |
| R6801 UnitedHealthcare | Medicare Advantage | 89,493 | 4% | 97% | 0d | Source |
| H4604 UnitedHealthcare | Medicare Advantage | 88,018 | 14.5% | 71% | 1d | Source |
| H3379 UnitedHealthcare | Medicare Advantage | 67,401 | 21.4% | 54.5% | 1d | Source |
| H3387 UnitedHealthcare | Medicare Advantage | 40,768 | 11.5% | 43.9% | 0d | Source |
| H0169 UnitedHealthcare | Medicare Advantage | 40,168 | 13.5% | 47.4% | 0d | Source |
| H0432 UnitedHealthcare | Medicare Advantage | 39,696 | 15.7% | 58.8% | 1d | Source |
| H0321 UnitedHealthcare | Medicare Advantage | 38,523 | 10.2% | 49% | 2d | Source |
| H0755 UnitedHealthcare | Medicare Advantage | 38,238 | 20.9% | 63.5% | 1d | Source |
| H3113 UnitedHealthcare | Medicare Advantage | 35,501 | 9.9% | 58.1% | 1d | Source |
| H3418 UnitedHealthcare | Medicare Advantage | 34,822 | 21.1% | 56.4% | 1d | Source |
| H0251 UnitedHealthcare | Medicare Advantage | 32,320 | 15.4% | 49.2% | 1d | Source |
| H5008 UnitedHealthcare | Medicare Advantage | 28,492 | 15.2% | 50.3% | 1d | Source |
| H1285 UnitedHealthcare | Medicare Advantage | 21,449 | 13.4% | 43.1% | 2d | Source |
| H2509 UnitedHealthcare | Medicare Advantage | 19,482 | 12.9% | 43.5% | 1d | Source |
| H2247 UnitedHealthcare | Medicare Advantage | 19,397 | 11.3% | 18.8% | 2d | Source |
| H2445 UnitedHealthcare | Medicare Advantage | 18,682 | 13.2% | 41.2% | 1d | Source |
| H3256 UnitedHealthcare | Medicare Advantage | 18,400 | 12.6% | 71.4% | 0d | Source |
| H1537 UnitedHealthcare | Medicare Advantage | 17,926 | 25.2% | 61.3% | 1d | Source |
| H3794 UnitedHealthcare | Medicare Advantage | 15,127 | 11.9% | 50.6% | 0d | Source |
| R0759 UnitedHealthcare | Medicare Advantage | 13,563 | 21.2% | 62% | 1d | Source |
| H5420 UnitedHealthcare | Medicare Advantage | 13,287 | 10.8% | 21.1% | 1d | Source |
| H2226 UnitedHealthcare | Medicare Advantage | 13,000 | 4.3% | 24.8% | 2d | Source |
| H8211 UnitedHealthcare | Medicare Advantage | 12,822 | 20.9% | 50.2% | 1d | Source |
| H7464 UnitedHealthcare | Medicare Advantage | 12,419 | 11.9% | 32.3% | 1d | Source |
| H6595 UnitedHealthcare | Medicare Advantage | 11,208 | 16% | 46.8% | 1d | Source |
| R2604 UnitedHealthcare | Medicare Advantage | 11,155 | 20.6% | 54.9% | 1d | Source |
| H0624 UnitedHealthcare | Medicare Advantage | 10,367 | 10.7% | 69.9% | 0d | Source |
| R5342 UnitedHealthcare | Medicare Advantage | 8,366 | 22.1% | 48.8% | 1d | Source |
| H2531 UnitedHealthcare | Medicare Advantage | 7,282 | 6.2% | 30% | 0d | Source |
| H9239 UnitedHealthcare | Medicare Advantage | 6,262 | 2.5% | 19.1% | 1d | Source |
| H0421 UnitedHealthcare | Medicare Advantage | 3,538 | 14.4% | 60% | 1d | Source |
| H5652 UnitedHealthcare | Medicare Advantage | 3,326 | 1.2% | 15.4% | 0d | Source |
| H2272 UnitedHealthcare | Medicare Advantage | 3,200 | 8.1% | 41.3% | 1d | Source |
| H0710 UnitedHealthcare | Medicare Advantage | 3,173 | 22.3% | 60.7% | 0d | Source |
| R3444 UnitedHealthcare | Medicare Advantage | 3,155 | 18.6% | 63.6% | 0d | Source |
| H7833 UnitedHealthcare | Medicare Advantage | 2,271 | 0.7% | 7.8% | 0d | Source |
| H1360 UnitedHealthcare | Medicare Advantage | 1,935 | 7.3% | 57.1% | 1d | Source |
| H1659 UnitedHealthcare | Medicare Advantage | 810 | 20.7% | 75% | 1d | Source |
| H3307 UnitedHealthcare | Medicare Advantage | 647 | 21.6% | 57.1% | 1d | Source |
| H2385 UnitedHealthcare | Medicare Advantage | 601 | 9.2% | 87.5% | 0d | Source |
| H0764 UnitedHealthcare | Medicare Advantage | 499 | 11.6% | 45.5% | 1d | Source |
| H2292 UnitedHealthcare | Medicare Advantage | 280 | 11.4% | 66.7% | 0d | Source |
| H6824 UnitedHealthcare | Medicare Advantage | 153 | 1.3% | 0% | 2d | Source |
| H6706 UnitedHealthcare | Medicare Advantage | 133 | 10.5% | 100% | 1d | Source |
| H2582 UnitedHealthcare | Medicare Advantage | 86 | 8.1% | 0% | 0d | Source |
| H5435 UnitedHealthcare | Medicare Advantage | 82 | 22% | 33.3% | 5d | Source |
| R7444 UnitedHealthcare | Medicare Advantage | 18 | 27.8% | 0% | 2d | Source |
| H4032 UnitedHealthcare | Medicare Advantage | 8 | 0% | 0% | 0d | Source |
What these numbers mean for your denial
Coverage Rights calculated a 12.9% prior-authorization denial rate for the Medicare Advantage contracts in 2025. In the calculated Medicare Advantage contracts appeal scope, 57.7% were reversed — most denials that got challenged did not survive review. The underlying contract or plan figures were published by UnitedHealthcare; Coverage Rights performed the stated rollup.
The practical takeaway is narrower: an initial denial can change on review. These aggregate rates describe past decisions within the stated reporting scope; they do not predict the result of an individual appeal.
Your appeal deadline depends on your plan type
UnitedHealthcare runs several kinds of plans, and the appeal rules follow the plan, not the insurer. Find the ladder and the deadlines for yours:
Common questions
What is UnitedHealthcare's prior authorization denial rate?
Coverage Rights calculated a 12.9% prior-authorization denial rate for the Medicare Advantage contracts reporting scope in 2025, using the public disclosure required by federal rule CMS-0057-F. Within the calculated Medicare Advantage contracts appeal scope, 57.7% were overturned.
How do I appeal a UnitedHealthcare denial?
Start with the appeal instructions in UnitedHealthcare's denial notice. An independent external, fair-hearing, or Medicare review may be available after the required internal review, but eligibility depends on the coverage program, plan funding, denial type, regulating jurisdiction, and whether the notice says internal review is exhausted. Use the pathway tool before choosing the next reviewer.
Where do these numbers come from?
Coverage Rights calculated the displayed rollup from UnitedHealthcare's public CMS-0057-F disclosures for 2025. The methodology note identifies the included reporting scope and weighting or aggregation method; source links lead to the underlying insurer-published records.